Think about: A heart attack. Everyone knows that crushing chest pain is a hallmark of a heart attack. But that shouldn't be the only symptom on your radar. Signs can be more subtle in women than in men, says Heather Rosen, MD, medical director of UPMC Urgent Care in North Huntingdon, Penn. As a result, young women tend to brush off early symptoms and avoid seeking help, sometimes mistaking the pain of a heart attack for indigestion or acid reflux. Watch out for uncomfortable pressure in your chest (not necessarily in the middle—and not everyone experiences this), as well as non-chest pain symptoms, such as discomfort in one or both arms, nausea or dizziness, which are more common in women, per a study in JAMA Internal Medicine. Cold sweats, shortness of breath, and pain in the back, neck, shoulder, or jaw are other possible symptoms. 

What to do: Anytime you suspect a heart attack, "err on the side of caution and call 911," advises Dr. Rosen. Once the ambulance arrives, the paramedics can perform an EKG and give you aspirin or another treatment en route to the hospital. Don't go to urgent care or your family doctor; they won't be able to run the necessary tests to evaluate your heart. 

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Sharon Kay
February 29, 2016

Right after her double bypass surgery at 57, Kit Cassak, of Scottsdale, Ariz., a self-described optimist, was her usual upbeat self; three months later she couldn't stop crying. "I'd be scared to go to sleep at night—I didn't know if I'd wake up in the morning," she says.

After years of battling depression as well as drug and alcohol addiction, Steve Buckles, 58, of Waterloo, Iowa, had a heart attack and quadruple bypass surgery. "Knowing to expect the depression meant I was able to deal with it as a temporary setback," says Buckles.

It took Bob Johnson a year to feel better emotionally after heart surgery.

Bob Johnson suffered from guilt and depression after receiving a heart transplant at age 61. "I felt awful that a 20-year-old had to die for me to live. It took me a year to feel better about that," says Johnson.

Jim McBride, of Dover, Del., started feeling anxious and depressed about a month after his heart attack in 2006. "It came out of nowhere. I had never had it in the previous 61 years of my life. It really affected my outlook and ability to concentrate on my recovery from the heart attack," says McBride, now 63.

Cassak wasn't prepared for the depression that hit her as she was recovering from heart surgery. She eventually sought counseling, and her therapist assured her that her feelings were normal. She also encouraged Cassak to try to go back to work, because she was feeling isolated, and to resume physical activity. Three months later Cassak was running again and feeling back to normal.

"I am a believer that depression is like a broken toe," Cassak says. "You may not be able to do something yourself, but if you go find out what you can do youll get past it much faster." She says she doesn't anticipate a relapse, but if it happens, she won't hesitate to seek outside assistance, a theme shared by others who have experienced cardiac depression.

"Had I been told before leaving the hospital, or soon after, about some of the potential effects of the heart attack, I probably would have gotten help sooner for the anxiety and depression and known what to expect," says McBride, a minister who initially hoped that his faith would get him through his depression. McBride finally turned to his primary care physician who prescribed an antidepressant, anti-anxiety medication, and therapy. "It immediately helped my mental state and allowed me to concentrate fully on my heart recovery," says McBride.

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